ukutshixa ipleyiti yoxande maxillofacial mini

Ipleyiti yokutshixa sisixhobo sokulungisa i-fracture enomngxunya otshixayo.Ipleyiti yokutshixa ivumela ithambo ukuba lidibane liqine ngakumbi kwipleyiti, lenze ilungu elinqunyulweyo lizinze ngakumbi emva kokumiswa kwakhona.

Iipleyiti zokutshixa zaqala ukusetyenziswa kwiminyaka eyi-20 edlulileyo kwi-spine kunye notyando lwe-maxillofacial ukuzinzisa iifractures ngelixa kunciphisa ukuchithwa kwezicubu ezithambileyo kunye nokulimala.

Ipleyiti yokutshixa sisixhobo sokulungisa isaphukile esinemingxuma enemisonto apho ipleyiti isebenza njengesixhobo sokulungisa iAngle xa kufakwe isikrufu esinentloko enemisonto yomibini. Imingxuma yomibini etshixayo nengatshixwayo inokubonelelwa ngokufaka isikrufu esahlukileyo. I-engile screw okanye ibholithi yintsimbi yokutshixa.Ukulungiswa kwentsimbi yentsimbi akuxhomekekanga kukukhuhlana kwethambo ukuqonda uqhagamshelo, kodwa kuxhomekeke ngokupheleleyo kulwakhiwo lokutshixa lwentsimbi ngokwayo.A Umsantsa othile unokushiywa phakathi kwepleyiti yentsimbi kunye nomphezulu wethambo, ophelisa impembelelo embi yoqhagamshelwano olunzima phakathi kwepleyiti yentsimbi kunye nethambo, kwaye iphucula kakhulu ukunikezelwa kwegazi kunye nokukhula kunye nokubuyiselwa kwe-periosteum.Umahluko oyintloko we-biomechanical phakathi ipleyiti yentsimbi yemveli kunye nepleyiti yentsimbi yemveli kukuba le yokugqibela ixhomekeke amandla ukukhuhlana kujongano ithambo-ipleyiti ukucinezela ithambo.

I-screw yokutshixa yi-self-tapping screw kwaye ingasetyenziswa ngaphandle kokucofa okanye i-drill drill.Akukho xinzelelo phakathi kwepleyiti yensimbi kunye ne-bone cortex, ngoko akukho xinzelelo kwi-periosteum, ukwenzela ukukhusela ukunikezelwa kwegazi kwe-periosteum. Ngokubhekiselele kubuchule botyando, inokufikelela kwiimfuno zokusebenza kancinci, kwaye inokukhusela ngokufanelekileyo unikezelo lwegazi lwendawo yokwaphuka, ukuze umsebenzi wokufakelwa kwamathambo ungafuneki.I-scaffold yokulungisa yangaphakathi i-elastic.Ebukhoneni bomthwalo, kukho ukuvuselela uxinzelelo phakathi kweebhloko zokuphuka, ezihambelana nokubunjwa kwefowuni kunye nokuphulukiswa kokuphuka.

Emva kokwaphuka kwe-maxillofacial, ikakhulu ukunciphisa kunye nokulungiswa.Umqondiso obalulekileyo wokunciphisa ukuphuka kwemihlathi kukubuyisela ubudlelwane obuqhelekileyo be-occlusal yamazinyo aphezulu nangaphantsi, oko kukuthi, unxibelelwano olubanzi lwamazinyo.Ngaphandle koko kuya kuchaphazela ukubuyiswa komsebenzi we-mastication. emva kokuphiliswa kokwaphuka.Zintathu iindlela eziqhelekileyo zokusetha kwakhona:

I-1.Ukunciphisa ukukhwabanisa: kwinqanaba lokuqala lokuqhekeka komhlathi, icandelo le-fracture lisebenza ngokulinganayo, kwaye i-displaced fracture segment ingabuyiselwa kwindawo eqhelekileyo ngesandla.

I-2. Ukunciphisa i-Traction: emva kokuphuka komhlathi, emva kwexesha elide (ngaphezu kweeveki ezintathu ze-maxilla, ngaphezu kweeveki ezine ze-mandible), i-fracture inenxalenye yokuphulukiswa kwezicubu ze-fibrous, ukunciphisa ngesandla akuphumeleli, Indlela yokunciphisa intambo ingasetyenziswa.Ukwaphuka kwe-mandibular fracture yenjongo ezininzi zokutsaleka komhlathi, ikwithambo le-mandibular inokususwa kwecandelo lokwaphuka lobeko lwecandelwana lwamazinyo lwe-arch splint, kwaye ke phakathi kwe-arch ye-arch splint kunye ne-maxillary, kunye ne ibhanti encinci yerabha ye-elastic traction, ukwenzela ukuba ibuyisele ngokuthe ngcembe ubudlelwane obuqhelekileyo be-occlusal.Emva kokwaphuka kwe-maxillary, ukuba icandelo lokuphuka litshintshela ngasemva, i-arch splint yamazinyo inokubekwa kwi-maxillary dentition, kunye ne-cap ye-plaster kunye ne-bracket yesinyithi inokufakwa. yenziwe entloko.Ukutsalwa kwe-elastic kungenziwa phakathi kwe-arch arch splint kunye ne-bracket yentsimbi, ukwenzela ukuba i-maxillary fracture segment ingabuyiselwa phambili.I-Horizontal gravity traction ingasetyenziselwa xa kufuneka i-traction force enkulu.

I-3.Ukunciphisa okuvulekileyo: Izibonakaliso zokunciphisa okuvulekileyo zibanzi.Ukunciphisa okuvulekileyo kufuneka kwenziwe xa icandelo le-fracture lisuswa ixesha elide kwaye kukho ukuphulukiswa kwe-fibrous okanye ukuphulukiswa kwe-bony malalignment, kunye nokunciphisa akukwazi ukufezekiswa ngokuguqulwa okanye ukutsalwa. Izicubu ze-fibrous ezenziwe kwi-dislocation yokuphulukisa phakathi kweziphelo eziphukileyo zokuphuka zikhutshwe okanye i-callus ikhutshwe, kwaye umhlathi uphinde uhlanjululwe ukuze ubuyele kwindawo yawo eqhelekileyo.Ukunciphisa okuvulekileyo ngokuqhelekileyo kusetyenziselwa ukuphuka okutsha okanye ukuphuka okuvulekileyo ngobunzima. ekunciphiseni ngesandla okanye ukungazinzi emva kokunciphisa.